VA community care by fax: Request for Service and medical records

A VA community care provider asks for care beyond an active referral on VA Form 10-10172, the Request for Service: one form per service, signed and dated, with supporting records, sent to the local VA community care office by HSRM, secure email, direct messaging, fax or permitted mail. VA processes it within 3 business days.

How do VA community care providers send a Request for Service?

VA community care providers send a Request for Service (RFS) on VA Form 10-10172 to the local VA community care office, by HealthShare Referral Manager (HSRM), secure email, direct messaging, fax (electronic or traditional) or mail where the VA facility permits it. VA's RFS requirements page asks for a separate form for each service request, with supporting records attached to the signed and dated form. VA processes requests within 3 business days and notifies the provider by the provider's preferred method, and the form leaves approval or denial to the VA facility's discretion.

The form itself prints four steps: complete it, attach the medical records and care plan, have the ordering provider sign and date it, and submit it by HSRM, fax or secure email. Optum's Community Care Network provider manual adds that the signature is necessary because the RFS is the physician order, and it asks for the form the same day the provider decides care is needed.

VA's Community Care Network page names Optum as administrator for Regions 1 to 3 and TriWest for Regions 4 and 5. TriWest's handbook for Regions 4 and 5 lists HSRM, an EDI 278 transaction, direct messaging, secure email, secure online file exchange and eHealth Exchange for an RFS, with no fax, so readers in those regions confirm the route with their VA facility and TriWest.

The table sets out each VA document, its form, where it goes and its rule.

When do you need a Request for Service, and what goes with it?

A Request for Service is needed whenever a Veteran needs care beyond what an active referral authorizes, and it goes with supporting records such as provider notes, care plans, lab results and radiology reports. VA's Standardized Episodes of Care page says services outside the scope of the authorized referral need additional VA approval before care is provided. TriWest tells providers to await that approval before rendering services, and Optum's manual says the claim will be denied if no new referral is received.

A routine durable medical equipment (DME) request goes on an RFS within 24 hours, or by the next business day, after the service that generated the prescription, and a DME rental is covered only for its first 30 days, with a longer rental needing an RFS submitted in advance. Item 10 on the form asks whether care is needed within 48 hours, and if it is, the form tells the provider to contact the VA facility directly. Under the COMPACT Act, acute suicide crisis care runs up to 30 days inpatient and 90 days outpatient, and Optum's manual requires an RFS for any extension.

VA's precertification page says VA no longer requires precertification before authorized care, effective September 8, 2026. VA's page on types of Veteran care says CCN providers must notify VA of emergency care within 72 hours, and that late notice may affect how claims are processed, though the claims still need to be submitted. Optum's manual sends that notice to the Emergency Care Centralized Notification Center, online or by phone.

Where do you find the right VA fax number?

The right VA fax number comes from the approved referral or from VA's facility contacts page, because some VA facilities run separate lines for separate purposes. Optum's manual sends medical documentation to the secure fax located on the approved referral, or to the Veteran's local VA medical center for urgent care. VA's facility contacts page lists care coordination contacts for each VA medical center or health care system by state, and some listings give a fax line marked "Request for Service ONLY".

VA's provider claims page says the Veteran's Integrated Control Number (ICN) and the referral number appear on the Approved Referral for Medical Care, VA Form 10-7080, issued by the referring VA medical center. VA takes faxed prescriptions when e-prescribing to a VA pharmacy fails, and the pharmacy fax number comes from the Community Care representative at the referring facility.

How fast do medical records go back to VA, and what goes on the cover page?

Medical records go back to VA within 30 calendar days of the Veteran's initial appointment under Optum's manual, and the approved referral number goes in the top right corner of the cover page. Optum also sets 30 calendar days from completing the care on the approved referral. TriWest's medical documentation page sets initial records 30 days from the initial appointment and final records 30 days from completion of the Standardized Episode of Care.

For urgent care, VA asks for records within 30 calendar days to the Veteran's home VA medical center by VHIE or secure fax, and VA's provider claims page asks for referral care records as soon as possible after care. VA's HSRM user guide says VA sends an automatic task to submit documentation seven days after a referral moves to Initial Care Given, and Optum's manual expects documentation within 24 hours of an urgent VA request.

TriWest asks for the Veteran's unique identifier, full name with suffix, date of birth and the referral number on each page, and Optum requires provider authentication on all documentation: a written signature, written initials or an electronic signature, plus the provider's phone number. Optum's manual also requires records to go both to VA and to the referring provider, and it needs no Veteran signature to share them, except from Part 2 substance use disorder providers, who must obtain one.

VA's fact sheet 27-02 lists the summary note when no further treatment is needed, the treatment plan and discharge medications for outpatient mental health, and it lets facilities add to that list but never remove from it. TriWest's behavioral health page tells providers to keep psychotherapy notes separate from the Veteran's medical record and to include medication monitoring and session start and stop times in it. The same page treats a newly identified suicide risk in a Veteran not referred for inpatient behavioral health treatment as a critical finding to call in to VA within 24 hours.

What is the difference between care coordination records and claims documentation?

Care coordination records go to the authorizing VA facility, and they do not satisfy claims documentation requirements, which apply only to unauthorized emergency care claims. VA's provider claims page says both, and it adds that authorized care claims need no supporting documentation. VA's Community Care Document Cover Sheet, VA Form 10-10143f, is used only for records on unauthorized emergent services, and records for referred, authorized care go back through care coordination.

What mistakes get a Request for Service denied or delayed?

VA denies a Request for Service that is missing supporting documentation or the provider's signature, and the instructions from VA, Optum and TriWest name the errors that delay one:

• One form covering several services, where VA asks for a separate form for each.
• An unsigned or partly completed form; Optum's manual requires it complete and signed, because the form is the physician order.
• Records faxed to a line a facility reserves for Requests for Service.
• A request for care needed within 48 hours sent as a routine RFS instead of contacting the VA facility directly, as the form asks.
• A new secure email started to VA; VA's care coordination tools page says providers can only reply to emails VA sends.
• A denied RFS left too long; Optum's manual gives 90 days from the date of denial to request referral reconsideration.

HSRM access needs an active Community Care Network agreement with Optum or TriWest or an active Veterans Care Agreement, an NPI listed in the agreement and an ID.me account for each staff member. Staff also complete VHA TRAIN training and are added through the organization's End User Tracker, and the HSRM guide asks users to log in at least once every 35 days to keep access. VA's referral and authorization site gives the role that signs an online RFS only to an MD, DO, NP, PA, DPT, DC, acupuncturist, massage therapist or respiratory therapist.

How do TRICARE, CHAMPVA and Veterans Care Agreements compare?

TRICARE, CHAMPVA and Veterans Care Agreements run the same paperwork on different rules: TRICARE East takes referrals online with fax as a fallback, CHAMPVA needs preauthorization for most mental health or substance abuse services, and a Veterans Care Agreement issues referrals through HSRM, secure fax, email or mail. On VA's Veterans Care Agreements page, changes that affect provider status are reported within 10 business days, as the agreement specifies. VA's template agreement, VA Form 10-10171, requires written notice of the providers who will perform authorized services at least 10 business days before they do, and it sends records to the mailing address or fax number on the authorization when secure electronic routes are unavailable.

VA's CHAMPVA page requires preauthorization for most mental health or substance abuse services. The CHAMPVA Guidebook says that in most cases advance approval is not needed, and its list of services that need it includes non-emergent inpatient mental health or substance abuse services.

Humana Military, the TRICARE East contractor, says on its referral page that all referrals and authorizations go through provider self-service. Its tip sheet keeps fax for non-urgent, non-emergent requests from facilities without internet access, and TRICARE East's referral fax number gives Humana Military's fax lines. Its referral FAQ puts fax processing at up to three to five days against up to three days online. Its clear and legible reports FAQ has the referred-to provider fax a consult report to the military facility within 10 business days of care, to the number on the referral's auto-fax confirmation.

TriWest's April 2026 Provider Pulse says TRICARE West still takes referrals and authorization requests by fax, and its TRICARE provider handbook wants consult reports back within 10 business days for outpatient care and 40 business days after an inpatient discharge. TRICARE's referrals page lets Prime enrollees see a network provider in their region for outpatient mental health visits without a referral.

How do you send VA paperwork from a HIPAA fax account?

VA paperwork from Fax Pigeon can lead with the page carrying the approved referral number at the top right, as Optum's manual asks, because the Fax Pigeon cover sheet is optional. Under the BAA signed at signup, a signed VA Form 10-10172 and its supporting records can go as one PDF from the browser or by email. Every delivered fax gets delivery proof, a record how to tell if a fax went through describes. VA's faxed referrals and replies arrive in the practice's shared inbox, and roles and assignment send each one to the person handling it.

* Official sources (VA, Optum) were read on October 19, 2026. Fax Pigeon prices and plan terms as of October 20, 2026.